MEDICARE: IHOSVANI MIGUEL MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1962749564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IHOSVANI MIGUEL MD PA

Provider Business Mailing Address
First Line	:	500 SE 17TH ST STE 301
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-2547
Country	:	US
Telephone Number	:	855-844-1545
Fax Number	:	855-844-1545

Provider Business Practice Location Address
First Line	:	500 SE 17TH ST STE 301
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2547
Country	:	US
Telephone Number	:	855-844-1545
Fax Number	:	855-844-1545

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IHOSVANI MIGUEL
Credential	:	MD
Telephone Number	:	786-290-1764

Provider Enumeration Date	:	01/16/2013
Last Update Date	:	06/02/2025

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